ABSTRACT
A multitude of antimicrobial agents have become available over the past two decades. Appropriate use of these drugs demands not only an understanding of the antimicrobial spectrum of the agent but of the necessary dose adjustments because of renal or hepatic impairment. The use of computer-assisted pharmacokinetic modeling for dosing potentially toxic drugs such as aminoglycosides and vancomycin should be utilized whenever possible.
Subject(s)
Acute Kidney Injury/drug therapy , Anti-Bacterial Agents/therapeutic use , Kidney Failure, Chronic/drug therapy , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacokinetics , Antifungal Agents/therapeutic use , Antiviral Agents/therapeutic use , Humans , Mycobacterium Infections/drug therapyABSTRACT
A comparison of different regiments of ribavirin (R), administered either orally or by aerosol, was performed in 16 elderly subjects (13 men, 3 women, mean age 63 +/- 8 years) considered to be in the "high-risk" category for complications from influenza as defined by the Centers for Disease Control. The subjects were divided into four groups. Group O-600 received 600 mg orally R every 8 hours for 48 hours followed by 200 mg every 8 hours for 72 hours for a total dose of 5.4 g (22.1 mmol). Group O-800 received 800 mg oral R every 8 hours for 24 hours followed by 400 mg every 12 hours for 96 hours for a total dose of 4.1 g (22.9 mMoles). Group A-40 received R (40 mg/ml) aerosolized through a small particle aerosol generator for 6 hours every 12 hours for 96 hours, yielding an average delivered dose of 6.2 g (25.4 mMoles) R. Group A-60 received aerosolized R (60 mg/mL) for 2 hours every 8 hours for 96 hours, yielding an average delivered dose of 4.6 g (18.8 mMoles) R. No hematologic or other laboratory abnormalities were associated with any of the regimens. Group O-800 and O-600 reached mean peak plasma R levels of 11.8 microM and 5.3 microM, respectively, after 18 hours of therapy. Subsequent administration of 20 mg R every 8 hours was sufficient to maintain a plasma R level greater than 7 microM. Among the aerosol groups, group A-40 approached steady state plasma R levels (8-10 microM) more quickly than group A-60.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Influenza, Human/drug therapy , Ribavirin/administration & dosage , Ribonucleosides/administration & dosage , Administration, Inhalation , Administration, Oral , Aged , Clinical Trials as Topic , Drug Administration Schedule , Female , Humans , Influenza, Human/blood , Influenza, Human/urine , Male , Middle Aged , Radioimmunoassay , Ribavirin/blood , Ribavirin/therapeutic use , Ribavirin/urine , Risk Factors , Time FactorsABSTRACT
A method is described for determination of 1,2-propanediol dinitrate in blood at concentrations ranging from 10 ng/ml up to 25,000 ng/ml. It used double ether extraction with manual shaking in order to complete sample preparation within 5 min. Samples are analyzed via gas chromatography-electron-capture detection using a column of 3% base deactivated SP-2250 on Supelcoport. This column provides excellent separation and little 1,2-propanediol dinitrate tailing.